title: Prognostic importance of objective nutritional indexes in patients with chronic heart failure.
abstract: BACKGROUND
  Although malnutrition indicates an unfavorable prognosis in some clinical settings, the association between nutritional indexes and outcomes for patients with chronic heart failure (CHF) is unclear.
  
  
  RESULTS
  All the previously established objective nutritional indexes were evaluated. The controlling nutritional status score (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) were determined for 388 consecutive patients with CHF (mean age 69.6±12.3 years). The prevalence of malnutrition in this cohort was 60-69%. Patients were followed prospectively, with the endpoints being death due to a cardiovascular event or re-hospitalization. There were 130 events, including 33 deaths and 97 re-hospitalizations, during a mean follow-up period of 28.4 months. Patients experiencing cardiovascular events showed impaired nutritional status, higher CONUT scores, lower PNI scores, and lower GNRI scores, compared with those who did not experience cardiovascular events. CONUT score [hazard ratio 40.9, 95% confidence interval (CI) 10.8-154.8], PNI score (hazard ratio 6.4, 95% CI 5.4-25.1), and GNRI score (hazard ratio 11.6, 95% CI 3.7-10.0) were independently associated with cardiovascular events. Kaplan-Meier analysis showed that there was a significantly higher incidence of cardiovascular events in patients who were malnourished than in those who were not.
  
  
  CONCLUSIONS
  Malnutrition was common in patients with CHF. Evaluation of nutritional status may provide additional prognostic information in patients with CHF.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Narumi
authors.forename: Takanori
authors.initials: T
authors.lastname: Arimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Funayama
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kadowaki
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Otaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shishido
authors.forename: Takehiko
authors.initials: T
authors.lastname: Miyashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies
keywords: Chronic heart failure; Malnutrition; Prognosis